Report gets out around 7:45 am. I do a quick round to introduce myself and make sure my patients are alive and safe. I get the med pass going by 8:00 am/8:15 am. I'm told to get my med pass completed by 9:15 am/9:30 am and it usually takes me until 9:45 am/10:00 am.
My biggest slow down factor, according to my preceptor, is I explain too much about the medications. I also have trouble getting out of "talkers" rooms. Another thing that slows me down is I ask the patients if they need anything and they usually need to go to the bathroom. Of course, I help them to the bathroom (which takes a long time with ortho patients). I'll call the tech to see if they can stay with the patient while I continue my med pass but they usually say they are busy and I end up having to stay with the patient and ambulate them back to bed.
Yeah, don't be rude, but just start walking out of the door, or sometimes I say , ok I will be back later, or I am going to visit some of your neighbors, and are all the meds passed new meds?? Some don't need a lot of education.
If a patient is alert and oriented they will want to take their Meds so they can get the heck outta there. With these people I leave them their cup of pills to take on their own. Will go back 15 min later to check if they took them
This would probably save a lot of time but there will be many instances of a patient dropping a medication that doesn't get noticed or a patient deciding they don't want to take one of the pills without discussing it with you. Also heard a story about a patient choking on a K-Clor tablet without the nurse being present.
I'm sure I'm coming off nit-picky but things like that happen way too often for me to chance it. Personally, I can save time elsewhere. Professionally, I'd get in trouble if management found out.
Loved this thread! I'm in my 5th week as a New Grad RN on a busy Med/Surg floor in a smaller community hospital with a lot of Geri patients and have all of these same issues with passing meds on time, reality vs text book medication delivery, politely escaping chatty patients, etc. Got some great tips here that I will definitely put into use! Thank you everyone!!
We have computers in the room, so for talkers or people who take forever to take meds, while they're taking meds/telling me about their 400 doctors visits this year, I do their assessment, chart it, and sometimes write all my notes/care plans.
Clustering care and meds is a skill you will acquire with time. But it's a conscious activity. I work with some nurses who have been there years who still can't get everything done in a timely manner.
I see absolutely nothing wrong with just flat out telling the pt/family "Sorry, but I have to keep going. More meds to pass."
And, unlike in LTC, med pass in a hospital isn't that huge of a chunk of the nurse's shift. Just tell the pt that you're passing meds now, but we can talk about (whatever they are concerned about) once you're done. Unless what they want to talk about is emergent, they can wait a bit. There's nothing unprofessional about that.
I don't know where the mentality of "treat each pt like they're the only one" began. They aren't the only pt. And there are important tasks that need to be done. The whole "customer service" mentality does nobody any good because it's predicated on a lie.
interesting topic of discussion. i will leave my own tips now, and hopefully it will help someone.
i work at a LTC , with about 28 residents. my med pass starts at 9 am should end before 12 which is lunch time. Most times i minutes before 12 (on a bad day when i am being interrupted a lot)
with me its all about, finishing on time and going home, this includes med pass.
how to finish med pass quicker
Get to Work 30 minutes early
take a look at the schedule rooster and take note of who you will be working with , the can's that are working with you and when at your unit make sure i get report and know who i am writing on, make a separate note so you can visit that, during my break time (yea work while you eat lol)
2. we get to work early so i can pre-check the residents that need vitals for meds, get a (working B/P machine) and check the resident b/p while i do my rounds, to get that out the way , or according to you facility policy, you must make sure your cna's have your vitals ready on time.
3. i count my narcs while while they are still in the bag, i hold it in their with one hand, pull it out, observe it and write on it. ( this makes it faster for me, might help you too, IDC)
4. G tubes, can be a little tricky, some are backed up, some resident are uncooperative, so you must figure out a working system for you, you should be able to press the hold flow button give meds and be back before the machine starts beeping. message me if you need more info on this one (347) 560-0109
5. MOST IMPORTANT; the med pass
With The med pass, like previously mentioned, stock before you start, it cuts down on time wasted. so make sure you are well stocked with whatever you may be running out of.
on the first drawer of the cart, i clear up the center space in the front-center, enough space to fit a resident's batch of blister packs
this way when you need to look through it for a residents medication, it is all faced in front of you, you just flip through it, with one hand, and when you get to the right med, you turn it faced down sideways.
put your water to the far right or left and your cups the the opposite end.
place your MAR in the center or if you are lucky you are using a computer documentation (we not not so lucky yet!)
open the MAR
find a resident
read the medication needed
flip through blister packs , with one hand, and when you get to the med, you turn that blister pack faced down sideways.
or if it is a stock med, you should find it (it usually on the first drawer too),
after you have found and placed all the needed med on the table or turned sideways down, then you can start preparing the medications for that resident.
afterwards you then sign the blister pack, if its a new blister pack , you must include the date and your initial, if its not , just write the data
after giving the med to the resident, return and sign your MAR for giving them.
it seems little confusing , but that's my system of med pass in a nutshell, its effective. but with anything in life, their is variance, things that we cannot control. we try to avoid distractions unless it is emergency.
to avoid med errors
make sure you sign the Narc book as soon as you pop the narc. (very important), don't wait until after.
AFTER preparing a residents medications from the blister pack, as we return the batch of blister packs, into the cart, TURN IN BACK SIDE FACING us, so we can only see the white, this way , we can minimize the margin of error by a lot.
during your break
at the cafeteria, sit back with your 24 report, and start writing on it, for the residents that are on it, also write on the nursing report as soon as you can, and flag them until you get your vitals to fill on it.
that's my little 2 cents,i hope someone got something from it. best of luck y'all from
other tips
make sure you catch the residents that comes around you, also if a resident is not around, prepare their med, pull out a tape, and write the resident name and room, and keep the med aside until you are finished, but most of the time, you will find them on the way to another resident, and you can give it to them then.
have your blister packs marked with a small red check mark in the right hand corner for easy identification for your shift's. It saves time flipping through all the meds. you just pull out those with the red checks and then double check that I'm giving the right med.
when doing med pass in the hallway, do it in z pattern, like do one patients room, do the next room, then a room across from it, then the next room, the a room across, doing this coupled with flipping the blister packs, will increase your med pass time by a lot, but the draw back is the use of a book MAR not a pc, so i guess the technique is best suited for pc documentation.
How many patients do you typically have? At my job we do bedside report. Max 6 patients. 7 on emergency basis (has never happened to me so far). bedside report gives me a chance to introduce myself, get an update on the patient while informing the patient of their plan of care as well. After report I know who needs pain meds the most, I've introduced myself, taken in information about the patient and I also feel that bedside report cuts out the chit chat from talkative nurses and gossip between shifts.
SleeepyRN
1,076 Posts
This is a wonderful thread and I'm picking good tied bits here and there. Thank you all who are responding; please keep the tips comimg :)